Multidisciplinary Program "Optimization of Drug Prescription" : Impact on the Quality of Drug Prescription in Hospitalized Elderly Patients

Potentially Inappropriate Medications Clinical Trial

— OPMED  

Official title:

OPMED STUDY: Multidisciplinary Program "Optimization of Drug Prescription" : Impact on the Quality of Drug Prescription in Hospitalized Elderly Patients

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT01947270
• Other study ID #: D50789
• Status: Completed
• Phase: N/A
• First received: July 26, 2013
• Last updated: September 27, 2017
• Start date: January 2013
• Est. completion date: June 2017

Study information

• Verified date: September 2017
• Source: Hospices Civils de Lyon
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

Drug prescription is a fundamental component of care for the elderly. Even if drugs are a chance for the older patient, because of changes in pharmacological, pharmacokinetic and pharmacodynamic parameters related with age and acute/or chronic pathologies, the risks associated with drug prescription, particularly those associated with potentially inappropriate medication (PIM), are increased in the elderly.

We suppose that many of hospitalized elderly have at least one prescribed medication without valid indication. Conversely, many diseases are currently undertreated in elderly patients: e.g. medicines used to treat heart failure and osteoporosis are underused in 20 to 70% of patients. Moreover, PMI prescription is associated with an increased of morbidity, mortality, risk of drug-related adverse events, utilization of health care system, care costs and impairment of quality of life. Thus, optimization of drug prescription is a major concern for improvement of the quality and safety of care in elderly.

The investigators' hypothesis is that a multidisciplinary program entitled "Optimisation de la Prescription MEDicamenteuse" ("Optimization of drug prescribing") focused on drug prescription optimization including a physician training to the specificity of the drug prescription in the elderly and a checklist allowing an adapted and standardized pharmaceutical analysis is effective in reducing PIM in elderly patients hospitalized in short-term medical and geriatric care departments.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 3055
• Est. completion date: June 2017
• Est. primary completion date: June 2017
• Accepts healthy volunteers: No
• Gender: All
• Age group: 75 Years and older

Eligibility

Inclusion Criteria:

• Male or female subject aged over 75 years hospitalized in one of the participating department

• Patient agreed to participate

Exclusion Criteria:

• Patient with a predictive length of stay equal or less than 48 hours

• Patients admitted in terminal illness

Related Conditions & MeSH terms

• Potentially Inappropriate Medications

Intervention

Other:
• " Optimisation de la Prescription MEDicamenteuse " ("Optimization of drug prescribing")
The multidisciplinary intervention program include: Awareness and training of doctors by two experts (a geriatrician and a pharmacist) within participating departments. Implementation of a checklist which aims to conduct an adapted and standardized pharmaceutical analysis

Locations

Country	Name	City	State
France	Hospices Civils de Lyon - Hôpital Edouard Herriot	Lyon

Sponsors (1)

Lead Sponsor	Collaborator
Hospices Civils de Lyon

Country where clinical trial is conducted

France, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Proportion of potentially inappropriate medications (PIM) prescribed in discharge of hospitalized patients from 75 years old.	Proportion of prescribed PIM will be expressed as the ratio of PIM to the total number of medication in discharge prescription sheet.; PIM will be identified by 2 experts (1 doctor and 1 pharmacist) based on criteria from the lists STOPP/START and Laroche.	at discharge (average 3 weeks)
Secondary	Total number of drugs prescribed per discharge prescription sheet		at discharge (average 3 weeks)
Secondary	Number of rehospitalization within 12 months following discharge		12 months after inclusion
Secondary	Number of emergency admission within 12 months following hospitalization		12 months after inclusion
Secondary	Mortality within 12 months after hospitalization		12 months after inclusion